Diagnosis and Treatment of Chronic Heart Failure Based on Thinking of Five Differentiation
10.13422/j.cnki.syfjx.20251418
- VernacularTitle:基于“五辨”思维探讨慢性心力衰竭的诊疗思路
- Author:
Kun LIAN
1
;
Lichong MENG
1
;
Manting YI
1
;
Lin LI
1
;
Fei WANG
2
;
Siyuan HU
1
;
Zhixi HU
1
Author Information
1. Hunan University of Chinese Medicine， Changsha 410208，China
2. The First Affiliated Hospital of University of South China， Hengyang 421001， China
- Publication Type:Journal Article
- Keywords:
thinking of five differentiation;
chronic heart failure;
precision diagnosis and treatment;
integration of traditional Chinese and Western medicine;
treatment by stages
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2026;32(5):160-168
- CountryChina
- Language:Chinese
-
Abstract:
Chronic heart failure （CHF） refers to a clinical syndrome in which the function or structure of the heart is changed due to damage to the original myocardium， resulting in reduced pumping and/or filling functions of the heart. In recent years， the mechanisms， pathways， and targets of traditional Chinese medicine （TCM） in the treatment of CHF have been continuously confirmed， and the application of TCM theories in guiding the syndrome differentiation and precise treatment of CHF is currently a research hotspot. On the basis of the syndrome differentiation and treatment in TCM， Professor LI Candong innovatively proposed the thinking of five differentiation： Disease differentiation， syndrome differentiation， pathogenesis differentiation， symptom differentiation， and individual differentiation. This article explores the clinical diagnosis and treatment of CHF from this thinking， emphasizing comprehensive syndrome differentiation， objective analysis， dynamic assessment， and individualized treatment. In terms of diagnosis， the first is to identify the disease name， cause， location， severity， and type of CHF， determine the type and its evolution， and clarify the process of transmission and transformation between deficiency and excess. Secondly， it is necessary to distinguish the authenticity， severity， primary and secondary， urgency and complexity of CHF syndromes， providing scientific guidance for syndrome differentiation and treatment. Thirdly， according to the symptoms and the principles of deficiency and excess， the physician should identify the core pathogenesis of CHF from the perspectives of Qi， blood， Yin， Yang， deficiency， stasis， phlegm， water， and toxins. Fourthly， from the macro， meso and micro levels， the physician should carefully distinguish the presence or absence， severity， authenticity， and completeness of the symptoms to guide the diagnosis and treatment process of CHF. Finally， personalized medication for CHF should be promoted based on the patient's gender， age， constitution， and living habits. In terms of treatment， based on the thinking of five differentiation， we propose that the treatment of CHF should integrate the disease and syndrome， clarify the pathogenesis， and apply precise treatment. The treatment should be people-oriented， staged， and typed， and the medication should be adjusted according to symptoms. This diagnostic and therapeutic approach is based on the holistic concept and syndrome differentiation and treatment， and combines the three causes for appropriate treatment， providing new ideas and insights for the diagnosis and treatment of CHF.
